2001-10-22_REPORT - M1997065

• Permit No: M1997065
• IBM Index Class Name: Report
• Doc Date: 10/22/2001
• Doc Name: Annual Fee/Report Notice
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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ANNUAL FEE and REPORT REQUEST G
PERMITTEE NAME: Stone Wholesale Corporation
PERMIT NO.: M-1997-065 �eIC
OPERATION NAME: Brownstone Quarry O LAI
ANNIVERSARY DATE: October 22,2001 Division of Minerals and Geology
ANNUAL FEE DUE: $281.00(Due on or before your anniversary date)
COUNTY: Larimer
According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator
_ shall submit the annual fee, a report and map showing the extent of current disturbances to affected land,
ma reclation accomplished to date and during the preceding year, new distur antes that are anticipated to occur -- —
during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning
of active operations, and the date active operations ceased for the year, if any.
Please attach your revised written annual report and annual report map to this form. Please note that an
adequately labeled map that clearly delineates and includes the above elements may suffice for a written report.
Division records indicate the following permittee contact information. Please verify and make any necessary
changes:
Permittee Contact Jim Striggow
Permittee Name: Stone Wholesale Corporation
Address: 4717 W. Lakeview Dr.
Fort Collins, CO 80526
Phone Number: [phone]
- - - Fax Number. — -
If you have additional comments and/or information that should be provided to the Division, please provide it
below or attach it to this form along with your written report and map. Annual Report instructions are enclosed.
Iire-
of Corporate Officer or Owner
2
Date
M TERM FFWASTERDOCUMENTS%M-AF-01